2020-11-12T12:28:59-06:00 2019-12-31 990 2019-01-01 581897274 Parkwest Medical Center PARK 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 JOHN T GEPPI EVP/CFO 8653746872 2020-11-12 168.85.177.4 2020-11-12 13:28:36 ES P 3D930A472F01CEA3FDB64A4D5B42C0182D7B7C6B 4CEA843006F037F323691C37D30308A58027C477 2019 2021-01-29 14:40:06Z James D VanderSteeg 100 Ft Sanders W Blvd Knoxville TN 37922 393127389 0 X https://www.treatedwell.com/ X 1990 TN Parkwest Medical Center operates a full-service acute care hospital located in west Knoxville, Tennessee, and a psychiatric hospital in neighboring Blount County, TN with a combined total of 462 beds. It is a member of the Covenant Health system. 18 16 2888 214 492459 0 531826 605858 358041034 385815319 39426 66486 3589657 3410895 362201943 389898558 531777 535374 0 0 109339451 116664088 0 0 0 216101673 238221766 325972901 355421228 36229042 34477330 264584394 333753120 33454636 46778666 231129758 286974454 X Parkwest Medical Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of the patient's ability to pay. 0 0 348133547 535374 377253103 Parkwest Medical Center ("Parkwest") admitted its first patient on December 10, 1973. It became a not-for-profit hospital in 1990 and joined the Covenant Health system in 1996. SERVICEWest Knoxville's largest medical center, Parkwest has an organizational culture focused on treating every patient and visitor with courtesy, compassion, and respect. It is best known for excellence in orthopedics, cardiology, surgical, emergency, labor and delivery, and behavioral health. Parkwest served 281,704 patients in 2019. Of these, 257,292 were outpatients and 24,412 were inpatients with an average length-of-stay of 4.60 days. Peninsula, a division of Parkwest Medical Center ("Peninsula") is the behavioral services division of Parkwest Medical Center and the region's largest provider of behavioral health services. Peninsula has a 155-bed hospital in Blount County providing mental health services for adolescents and adults. Peninsula also provides outpatient services in four counties. PUTTING PATIENTS FIRSTIn 2019, Parkwest was recognized by U.S. News & World Report as the #7 hospital in Tennessee, the #2 hospital in Knoxville metro area, and rated as a high performing hospital by U.S. News & World Report for hip and knee replacements, COPD, and heart failure measures. BlueCross BlueShield gave the hospital a Blue Distinction Center for Knee Replacement and Hip Surgery, Maternity Care, and Spine Surgery. Parkwest's Joint Replacement Center has the second highest patient volume in the state. The Joint Commission has designated the hospital as an Advanced Primary Stroke Center, and Parkwest is a member of Covenant Health's stroke hospital network, which links Covenant Health's member hospitals in providing rapid diagnosis and treatment of stroke. The heart hospital at Parkwest has been designated by The Joint Commission as a top performer in heart, pneumonia, and surgical care. Parkwest is participating in a national initiative related to improving survival rates and outcomes for patients experiencing cardiogenic shock, and has earned the Gold Plus Quality Award from The American Heart Association, recognizing consistent compliance with evidence-based quality measures for care of patients experiencing heart attacks. The American Heart Association also awarded the hospital with a Silver Award for non-STEMI quality measures.The Childbirth Center at Parkwest Medical Center was recognized by the Tennessee Department of Health and Tennessee Hospital Association with the BEST FOR BABIES Award for efforts to reduce infant deaths. The "BEST for Babies" award focuses on hospital excellence for breastfeeding, early elective delivery reduction and safe sleep for Tennessee babies.Parkwest consistently receives excellent safety and customer satisfaction ratings from multiple survey sources.IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHThe Tennessee Association of Mental Health recognized Peninsula's transitional task force as a program of excellence, and in 2018 Peninsula helped create the area's first suicide support group formed for those who have lost a loved one to suicide.Parkwest provided close to $259,000 worth of taxi/transportation vouchers to patients who were discharged and had no transportation available, and rent and security depostits for psych patients transitioning to independent living. Employees participate in the Greater Knoxville Heart Walk, raising funds and awareness for heart disease, and the March of Dimes March for Babies, which focuses on improving the health of newborns and infants. Parkwest also participates in local health fair screenings for area businesses and groups, usually providing carotid ultrasound screenings and physical therapy ergonomic education, as well as stroke education.The hospital has developed an "Honor Walk," a recognition of patients who have chosen to be organ donors in the event of their death. When this occurs, staff members gather in the hallways to pay final tribute as the patient is taken to the operating room for the organ donation procedure. COVENANT HEALTH SYSTEMParkwest is a member of Covenant Health. Covenant Health is a comprehensive, community-owned health system dedicated to improving the health of the people it serves. Established in 1996 by the consolidation of Fort Sanders Health System, Knoxville, Tennessee, and MMC HealthCare System in Oak Ridge, Covenant Health is governed by a voluntary board of directors comprised of community leaders and medical professionals. With more than 10,000 employees, affiliated physicians and volunteers, Covenant Health is the Knoxville area's largest employer and has been named a Best Employer five times by Forbes. Covenant Health includes nine acute care hospitals in East Tennessee: Methodist Medical Center of Oak Ridge, Fort Sanders Regional Medical Center and Parkwest Medical Center in Knoxville, Fort Loudoun Medical Center in Lenoir City, LeConte Medical Center in Sevierville, Morristown-Hamblen Healthcare System in Morristown, Roane Medical Center in Harriman, Claiborne Medical Center in Tazewell and Cumberland Medical Center in Crossville. It also includes Peninsula, a division of Parkwest Medical Center, a behavioral health hospital in Blount County, Tennessee.Affiliated organizations include Thompson Cancer Survival Center, Thompson Oncology Group, Fortress Corporation and Subsidiaries, Covenant HomeCare, and Fort Sanders Perinatal Center. Philanthropic organizations include Fort Sanders Foundation and the Thompson Cancer Survival Center Foundation in Knoxville, Methodist Medical Center Foundation in Oak Ridge, Dr. Robert F. Thomas Foundation in Sevierville, and Morristown-Hamblen Hospital Foundation in Morristown. Funds raised by the foundations provide services, equipment and other resources for excellence in patient care.Parkwest, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served. 348133547 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 217 0 1 2888 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Amy DeLong 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Gerald Boyd Director 0.00 1.00 X 0 1550 0 Willard Campbell MD Director 0.00 1.00 X 0 0 0 Michael Casey MD Director 0.00 1.00 X 0 0 0 Ronni Chandler Director 0.00 1.00 X 0 1343 0 Mitchell Dickson MD Former Director (through Aug. 2019) 0.00 1.00 X 0 1489 0 James Fitzsimmons Director/Chair 0.00 1.00 X X 0 1563 0 James Gibson Director 0.00 1.00 X 0 1495 0 Amber Wisner Director 0.00 1.00 X 0 1071 0 Timothy Matthews Director 0.00 1.00 X 0 1733 0 Larry Mauldin Director 0.00 1.00 X 0 1507 0 Joseph Metcalf MD Director 0.00 1.00 X 0 12447 0 Dave Miller Director 0.00 1.00 X 0 1413 0 Alvin Nance Director 0.00 1.00 X 0 1378 0 Linda Ogle Director 0.00 1.00 X 0 0 0 Roger Osborne Former Director (through April 2019) 0.00 1.00 X 0 0 0 King Purnell Director 0.00 1.00 X 0 0 0 Randy Reid MD Former Director (through Nov. 2019) 0.00 1.00 X 0 1202 0 Cosby Stone Director 0.00 1.00 X 0 1068 0 Carl Storms Director 0.00 1.00 X 0 1307 0 Joe Sutter Director 0.00 1.00 X 0 1528 0 Richard Swanson Former Director (through Sept. 2019) 0.00 1.00 X 0 0 0 James D VanderSteeg President & CEO 0.00 50.00 X X 0 1798925 207223 John T Geppi EVP/CFO 0.00 50.00 X 0 980571 28517 Neil A Heatherly President & CAO 50.00 0.00 X 0 603075 34724 M Scott Hamilton VP - Financial Services 40.00 10.00 X 213950 0 33997 Elizabeth Clary VP-Behavioral Health 50.00 0.00 X 185577 0 22338 W Jason Draper VP - Support Services 50.00 0.00 X 177775 0 26258 Lynn C Cagle VP - Chief Nursing Officer 50.00 0.00 X 165980 0 29896 John G Kupfner MD Physician - Behavioral 40.00 0.00 X 370777 0 42200 Donna G McKenzie MD Physician - Behavioral 40.00 0.00 X 291866 0 20451 Shyam P Vuyyuru MD Physician - Behavioral 40.00 0.00 X 291715 0 41280 Surendra K Sharma MD Physician - Behavioral 40.00 0.00 X 257657 0 39389 Melanie R Fuertes-Hunt MD Physician - Behavioral 40.00 0.00 X 247199 0 44899 2202496 3414665 571172 64 0 1 0 Robins & Morton Group Dept 5870 POBox 11407 Birmingham AL 35246 Construction & Mgmt Services 35942870 Siemens Medical Solutions USA 40 Liberty Blvd Malvern PA 19355 Maintenance & Support 2213793 Medic Regional Blood Center 1601 Ailor Ave Knoxville TN 37921 Blood Processing 1597858 Angelica Textile Services Inc 1105 Lakewood Parkway Ste 210 Alpharetta GA 30009 Linen Services 1381768 Volunteer Perfusion LLC PO Box 30092 Knoxville TN 37930 Perfusion Services 1253036 48 183419 366256 56183 5910 605858 Net Patient Revenue 622110 376848831 376848831 Pharmacy 446110 8530128 267756 134965 8127407 Laboratory 621500 423771 423771 Rental Income - Exempt Affiliate 531120 12589 12589 385815319 65736 65736 3693168 3228831 464337 464337 -66277 530614 750 0 750 750 750 Cafeteria 722514 2121072 2121072 Gift Shop 453220 555622 555622 Support Services 812900 193883 122482 71401 75981 1445 74536 2946558 389898558 377253103 492459 11547138 X 17429 17429 517945 517945 855771 855771 93515232 91845964 1669268 2892088 2848371 43717 12722197 12135353 586844 6678800 6494440 184360 31958444 31100435 858009 128240 128240 41345892 41139981 205911 396913 388293 8620 2238100 1790919 447181 7317050 6236592 1080458 234253 212999 21254 189657 176121 13536 59220 59220 18905952 18807279 98673 555355 482331 73024 Medical Supplies 112469194 112469194 Unrelated Business Inco 150080 150080 Bad Debt 14761550 14761550 Minor Equipment 2443518 2074973 368545 5068348 4574158 494190 355421228 348133547 7287681 0 8045 8645 -704272 -4645986 37477169 41903879 6327624 7003537 1390527 1677984 557290151 274400229 218882827 282889922 1202474 4915139 264584394 333753120 30583392 39034642 78600 3272747 2792644 4471277 33454636 46778666 X 231129758 286974454 231129758 286974454 264584394 333753120 X 34477330 89309 21278057 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 166295 3203 6783 6783 169497 163863 2431 9524 9524 166295 156155 7707 9355 9355 163863 65512 90643 2227 2227 156155 64918 594 1913 1913 65512 0.00000 1.00000 0.00000 0 1 1 20508680 20508680 297330149 111329373 186000776 290827 256490 34337 237451187 162814366 74636821 1709308 1709308 282889922 Due to Affiliates, Net 1176183 Due to Third Party Payors 1769799 Long-term Deferred Compensation 784444 Long-term Reserve for Workers Comp 732156 Unclaimed Property 8695 4471277 X Part V, Line 4: Fort Sanders Foundation maintains two permanent endowment funds on behalf of Parkwest Medical Center. The Wayne Heatherly Excellence in Patient Care Endowment Fund was established to promote and encourage excellence in clinical quality and patient care by providing educational assistance to employees, recognizing and awarding nominated employees for their commitment to patient care excellence, and to help meet patient care needs. The Lewis S. Howard Endowment Fund was established to support patient scholarships for deserving phase II outpatient cardiac rehab patients at Fort Sanders Medical Center and Parkwest Medical Center. The principal of the permanent endowments will be kept intact in perpetuity and only the income generated will be distributed for endowment fund purposes. Part X, Line 2: Excerpts from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Parkwest Medical Center: Covenant and certain of its subsidiaries or controlled entities are exempt from income taxes pursuant to Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes on qualifying activities has been made for these entities in the accompanying consolidated financial statements. However, certain entities and operations are subject to income taxes. Covenant had no unrecognized tax benefits at December 31, 2019. As such, no interest or penalties were recognized in the consolidated financial statements related to unrecognized tax benefits. At December 31, 2019, tax returns for 2016 through 2019 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition or disclosure under GAAP at December 31, 2019. 1 1 X 1 X 1 X 1 1 1 0 1 1 11954261 696886 11257375 0.03300 51446535 40466812 10979723 0.03220 5890115 4564407 1325708 0.00390 69290911 45728105 23562806 0.06910 616269 616269 0.00180 728 728 0.00000 21574983 7609227 13965756 0.04100 94830 94830 0.00030 22286810 7609227 14677583 0.04310 91577721 53337332 38240389 0.11220 23444 23444 0.00010 55308 55308 0.00020 6625 6625 0.00000 85377 85377 0.00030 1 14761550 4753219 78403056 88269977 -9866921 X 1 1 2 1 Parkwest Medical Center 9352 Park West Blvd Knoxville TN 37923 https://www.treatedwell.com 00000042 X X X A 2 Peninsula a division of Parkwest Medical Ctr 2347 Jones Bend Road Louisville TN 37777 https://www.peninsulabehavioralhealth. 00000042 X Behavioral Hospital A Parkwest Medical Center 0 0 1 X X X X X X X X 17 1 1 1 1 X See Part V, Page 8 X 1 17 1 See Part V, Page 8 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.treatedwell.com/financial-assistance/ X https://www.treatedwell.com/financial-assistance/ X https://www.treatedwell.com/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Parkwest Medical Center, - Facility 2: Peninsula, a division of Parkwest Medical Ctr. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 5: Facility Group AIn conducting its most recent Community Health Needs Assessment ("CHNA"), Parkwest Medical Center ("Parkwest") partnered with the Knox County Health Department and the Community Health Council. Community hospitals worked collaboratively with the Health Department and Health Council along with local healthcare providers, governmental agencies, and dozens of community stakeholders. The Knox County Health Department convened monthly data group meetings with assessment partners to organize and coordinate the qualitative and quantitative data collection efforts. The qualitative data consisted of 12 focus groups, 26 key informant interviews and a quality of life survey with more than 2,000 responses. A Behavioral Risk Factor Survey (BRFS) and Youth Risk Factor Survey (YRFS) were conducted as well. Epidemiology staff compared local and state level data, data from the surveys, and mortality and disease prevalence data. Public input on a summary of the assessment was sought in person and online. The Community Health Council assembled subject matter experts on the top 20 issues to score the health priorities by 1) size of the problem, 2) seriousness of the problem, 3) effectiveness of interventions, and 4) feasibility of available interventions in our community. Representatives from the Community Health Council and the Knox County Health Department met with area hospital executives and administrators of large physician practice groups to present the outcomes. Thus, top priority goals for the community were a collaborative effort from all parties involved. Community Health Council and Data Collaborative Group members are listed in the CHNA. Part V, Section B, Line 4. It was determined per audit that while the Community Health Needs Assessment ("CHNA") was prepared as of December 31, 2016, it was completed on May 8, 2017 with board approval. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 6a: Part V, Section B, line 6a: Facility Group AKnox County hospitals who participated in the "Together! Healthy Knox" initiative included Parkwest Medical Center, Fort Sanders Regional Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 6b: The CHNA could not have been completed without the leadership of the Knox County Health Department and the "Together! Healthy Knox" Leadership Team. Their expertise, use of the national Mobilizing for Action through Planning and Partnerships (MAPP) process, meeting facilitation and guidance ultimately resulted in the most comprehensive health assessment process ever undertaken in Knox County. Other community organizations who participated in the CHNA process were Child and Family Tennessee, City of Knoxville, Knoxville Academy of Medicine, Knoxville Area Coalition on Childhood Obesity, Knoxville Chamber of Commerce, Knoxville Police Department, Knoxville Community Development Corporation, Helen Ross McNabb Center, Interfaith Health Clinic, Knox County Government, Metropolitan Drug Commission, and community members from many other organizations. A more extensive list is published in the assessment. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 11: Part V, Section B, line 11: Facility Group AOf the significant findings from the assessment, Parkwest is focusing its resources on the following:Mental Health - Peninsula, a division of Parkwest Medical Center, ("Peninsula") became a Health Link provider beginning in 2016, serving 678 mental health consumers in our region. This program ensures that clients receive comprehensive case management, care coordination, health promotion, patient and family care support and referrals to additional support as needed. In 2019, Peninsula served 1,249 clients. - Women in Treatment - provides comprehensive treatment to uninsured women aged 18-64 who are currently battling addiction. Fifty-six women were served in 2019.- KARM Partnership - Peninsula employs a staff member to serve as a liaison between the hospital inpatients and the Knoxville Area Rescue Mission. Peninsula continues to employ an outreach specialist to work with Knoxville Area Rescue Mission clients in 2019. Seventy clients, with 32 receiving active case management, were provided services in 2019.- Youth Indigent Program - Peninsula admits an average of 4-5 children and adolescents without a funding source each year. Total cost of care to facility is $12,600-$15,750 per year.Decrease Opioid Abuse- Peninsula no longer prescribes opioids in its outpatient clinics.Decrease Tobacco Use Among Youth and Pregnant Women- Peninsula Peer Support Program in Blount, Knox and Sevier Counties all offer smoking cessation classes using a curriculum approved by the State of Tennessee.Increase Access to Safe Greenways, Sidewalks and Parks- Parkwest is a major sponsor of the annual Covenant Health Knoxville Marathon. In 2019, the Covenant Health Knoxville Marathon had 7,766 participants in the various events including a Kids Run, 5K, Relay Teams and half and full marathons. This was the 15th year of supporting the marathon at a cost of nearly $80,000. At the end of the event each year $15,000 - 18,000 is given back to the community from the event proceeds to support additional greenways, walking trails and programs that promote physical activity. - Dogwood Patch Program - The fourth annual Dogwood Patch program was held in 2019 in collaboration with the Dogwood Arts organization. Residents who walk 25 miles or more of Dogwood Trails during a two month period earn an embroidered patch. A new patch is designed each year. In 2019, 113 residents participated.- Covenant Health Biggest Winner Program - a twice a year program for employees to focus on weight loss and improving their personal health biometrics. Local trails are used for the exercise component. The program culminates in the participants finishing their program by participating in either the 5K run/walk of the Covenant Health Knoxville Marathon or the Subway Race for Cancer 5K run/walk. In 2019, 33 employees participated in the Biggest Winner Program. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 16j: All other ways in which the hospital widely publicizes the FAP are discussed in detail in Part VI, Line 3. Part V, line 7a, CHNA website https://www.treatedwell.com/community-health-needs-assessment/ Part V, line 10a, Implementation Strategy Website https://www.treatedwell.com/community-health-needs-assessment/ Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Parkwest Medical Center, - Facility 2: Peninsula, a division of Parkwest Medical Ctr. Part V, Line 20d, Presumptive Eligibility Determinations The hospital follows the eligibility procedures as detailed within the FAP and does not make presumptive eligibility determinations. 15 1 - Thompson Radiation Oncology Services 9711 Sherrill Blvd Knoxville TN 37932 Oncology Radiation Therapy 2 - Hyperbaric Center at Parkwest 9300 Park West Blvd Knoxville TN 37923 Outpatient Wound Care Services 3 - Peninsula Outpatient Center - Knox 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient Mental Health Facility 4 - Thompson PET Services 9711 Sherrill Blvd Knoxville TN 37932 PET Imaging Services 5 - Parkwest Comprehensive Breast Center 9330 Park West BlvdSuite 103 Knoxville TN 37923 Breast Imaging Center 6 - Parkwest Cardiac Diagnostics 9320 Park West Blvd Knoxville TN 37923 Cardiac Diagnostic Services 7 - Peninsula Knox Outpatient Pharmacy 1451 Dowell Springs Blvd Knoxville TN 37919 Pharmacy 8 - Peninsula Outpatient Center - Blount 210 Simmons Street Maryville TN 37801 Outpatient Mental Health Facility 9 - PWMC Boulevard Surgery Center 9300 Park West Blvd Knoxville TN 37923 Ambulatory Surgery Center 10 - Therapy Center West 280 Fort Sanders West Blvd 201 Knoxville TN 37922 Physical, Occupational & Speech Therapy 11 - Peninsula Outpatient Center - Sevier 1104 Foxwood Drive Sevierville TN 37862 Outpatient Mental Health Facility 12 - CROPPROP 280 Fort Sanders West Blvd 205 Knoxville TN 37922 Cardiac & Pulmonary Rehabilitation 13 - Peninsula Outpatient Center - Loudon 423 Medical Park Drive Suite 400 Lenoir City TN 37772 Outpatient Mental Health Facility 14 - Peninsula Adolescent IOP 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient Alcohol & Drug Rehabilitation 15 - Peninsula Adult IOP 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient Alcohol & Drug Rehabilitation Part I, Line 3c: In addition to the FPG (federal poverty guidelines), Parkwest utilizes an asset test as a factor in determining eligibility for free or discounted care. Ten percent (10%) of the patient/guarantor's net assets will be added to income for determination of total annual income. The guidelines for determining assets include, but are not limited to, primary dwelling (and attached land), automobiles, liquid assets, investments, farm land, business property, rental property, farm and/or business equipment including livestock and crops. All real property will be considered at fair market value. The values of both real and personal property will be reduced by any existing liabilities incurred by the applicant in obtaining the assets (net assets). Part I, Line 6a: Covenant Health, the parent company of Parkwest and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. Part I, Line 7: Amounts on Lines 7a-7c and certain program costs included in Line 7g are from the hospital's cost accounting system, which addresses all patient segments. Other community benefit expenses are at cost from the general ledger. Part I, Line 7g: Subsidized health services includes the difference between the cost of services and the payments received for those services. The cost of providing in-patient and out-patient psych services exceeded the payments received by $1,125,176. The organization has also included $12,840,580 in physician sponsorship fees in total subsidized health services. All subsidized health services included on line 7g are for services that would otherwise be unavailable in the community or be below the community's needs. Part I, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 24a, but subtracted for purposes of calculating the percentage in this column is $14,761,550. Part II, Community Building Activities: Parkwest cares for the whole person and recognizes that improved social and economic conditions may lead to the improved health and well-being of the community. The hospital's community building activities and those of its parent organization, Covenant Health, address many of the root causes of health problems, such as poverty and homelessness, and help find solutions to alleviate the symptoms.An allocation of the Parent's community building expenditures has been made to each member hospital in proportion to the financial contribution of each to the health system. Covenant Health is not a hospital and does not file Schedule H with its Form 990. Contributions in 2019 were made to organizations meeting the community's needs by providing: - The basic needs of life including temporary shelter, food and clothing (Catholic Charities and Ladies of Charity) - Youth mentoring, development and after-school programs (Emerald Youth Foundation, Boys and Girls Club, Great Smoky Mountain Council, Young Life, Williams Creek Youth Foundation and the Dollywood Foundation) - Business recruitment and marketing initiatives that boost economic development (East Tennessee Economic Development Agency, Innovation Valley, Inc., and Knox Area Chamber of Commerce) - Leadership development programs and workshops (Leadership Knoxville and Knoxville Urban League) - Assistance and special programs for at risk older adults, people with physical and mental challenges, and abused and neglected children (Helen Ross McNabb Center, Senior Citizens Home Assist, Sertoma Center, Inc.) - Improve access to health services (East TN Children's Hospital, Interfaith Health Clinic, St. Mary's Legacy Clinic, and Knoxville Academy of Medicine) - Programs supporting patients and their families (Alzheimer's Tennessee, Compassion in Action, and Random Acts of Flowers) Part III, Line 2: Bad debt expense on Part III, Line 2 is the amount recorded in the organization's financial statements. Discounts and payments on patient accounts are netted against bad debt. The allowance for bad debt is determined based on management's assessment of factors including the age of the accounts, historical collections data, and industry standards. Part III, Line 3: At regular intervals, the Vice President of Revenue Cycle analyzes all self-pay accounts receivables to identify patients who may have been eligible for charity care during a particular period or year. Because this analysis does not yield a final determination of eligibility due to various factors including but not limited to charity applications still in process, failure of eligible patients to submit their charity application, and applications still under consideration, further analysis of the accounts comprising the self-pay accounts receivable is conducted. The accounts for which a patient was contacted to apply for charity care include an identifier; these charity-identified accounts are then categorized according to status. A ratio of the dollar amounts of those accounts whose charity application is in process or has been approved divided by the total self-pay accounts receivable is computed. This ratio is applied to the bad debt expense total to determine the estimated amount of the bad debt expense attributable to patients eligible for charity care according to the hospital's policy. Part III, Line 4: Note B to the 2019 Audited Consolidated Financial Statements of the Covenant Health system, of which Parkwest is a member, states: Patient accounts receivable are reported net of an estimated allowance for contractual adjustments and an allowance for implicit price concessions. Covenant's policy does not require collateral or other security for patient accounts receivable and Covenant routinely accepts assignment of, or is otherwise entitled to receive, patient benefits payable under health insurance programs, plans or policies. Part III, Line 8: Medicare Shortfall: Parkwest believes that all of the $9.86 million shortfall reported in Line 7 should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in our community. This year, Medicare patients accounted for 27% of total patient days, (29,522 out of 109,417 total). The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. Costing Methodology: Parkwest used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations. Part III, Line 9b: Parkwest utilizes a look-back method to determine amounts generally billed ("AGB") to establish the maximum amount that will be charged to individuals eligible under the financial assistance policy ("FAP") for emergency or other medically necessary care. Self-pay patients of Parkwest automatically receive a 70% discount on charges based on the facility's calculated AGB. Self-pay patients of Peninsula receive a 60% discount. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 90% charity care. For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay.Parkwest makes reasonable efforts to determine a patient's eligibility under the facility FAP. All collection activity will be halted if a charity application is received and will remain on hold until a determination is made by Parkwest and communicated in writing to the responsible party. If the charity application is approved, all collection activities taken will be reversed and any amounts paid above the amount required will be refunded. Patients/guarantors who qualify for partial financial assistance are responsible for paying any balance remaining after the charity adjustment and third party payments. Parkwest will not engage in extraordinary collection actions ("ECA") before it makes reasonable efforts to determine whether an individual who has an unpaid bill is eligible for financial assistance. Reasonable efforts to determine whether the individual who has an unpaid bill is eligible for financial assistance include notification to the individual of the FAP, contacting individuals who have submitted incomplete financial assistance applications regarding how to complete the application and allowing a reasonable time period to do so, and reviewing completed applications for financial assistance eligibility.Parkwest does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by Parkwest. Parkwest will not defer or deny medically necessary care because of nonpayment for previously provided care whether it was covered or not covered under the charity program. Part VI, Line 2: While the CHNA is a formal means by which the health system assesses the needs of the community, there are many informal networks that give the Covenant Health hospitals a sense of community issues and needs. Parkwest obtains additional community information through the service of its employees with the United Way of Greater Knoxville, local chambers of commerce and Rotary clubs, the Metropolitan Drug Commission, a local alternative high school, the Legacy Parks Foundation, and the Knoxville Area Coalition on Childhood Obesity. Covenant Health, the parent organization, maintains community benefit professionals working year-round to ensure that all hospitals are assessing and addressing the needs of the communities served. Part VI, Line 3: Parkwest informs patients and other persons who may be billed for patient care about its financial aid policies by posting signs in highly visible areas of the hospital and including information about the financial aid policy in patient booklets placed in all inpatient rooms. In addition, the FAP and application are available via the facility website and notice of the availability of financial assistance is communicated via patient billing statements. The following sign is posted in all lobby areas:Financial Assistance: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health, and its member hospitals, that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, staffs of Parkwest Medical Center are available to assist you with your financial needs. If you are an uninsured person with no public or private source of payment for medical services, Parkwest Medical Center, in compliance with Tennessee Code Annotated, Title 47, Chapter 18 and Title 68, will provide at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 865-373-1244, Monday through Friday between the hours of 8:00 a.m. and 4:30 p.m. Parkwest employs a financial counselor who meets with uninsured patients. In addition, Parkwest directs inpatients and observation patients on how to apply for Tenncare and provides instructions for joining the Healthcare exchange. The FAP states that patients who are unable to pay and have exhausted all sources of payment assistance may be screened for potential charity care eligibility. According to the policy, the financial counselors initiate screening of the patient and/or guarantor by obtaining income and other financial information to determine eligibility for charity care or discounted services.Inpatient and observation patients without insurance receive a packet of information from the case managers on the nursing units. This packet includes a Financial Assistance Application, "How to Apply for Tenncare and instructions on the Healthcare Exchange. Tenncare applications are made online or by phone through the Healthcare Exchange process. Also included in the packet is how to apply for the Qualified Medicare Beneficiary program. Part VI, Line 4: Parkwest is located in the west area of Knoxville, Tennessee. Although located in metropolitan Knox County, Parkwest receives many specialty referrals from outlying hospitals and physicians and serves patients from 16 diverse counties, a mix of urban, suburban and rural. According to internal hospital data for 2019, 47% of the inpatient and 59% of the outpatient cases came from Knox County residents.Parkwest also provides mental health services to the region through its behavioral health division, Peninsula. Peninsula is East Tennessee's leading provider of behavioral healthcare services. Peninsula offers a complete range of mental health and alcohol/drug treatment programs. In addition to outpatient centers in Blount, Knox, Loudon and Sevier counties, care is also offered at Peninsula, a 155-bed inpatient facility which serves more than 5,000 patients annually.According to 2019 data from the County Health Ranking report from the Robert Wood Johnson Foundation, the population of Knox County is 461,860. The percent of the population that is 65 years or older constitute 15.4% of the residents. The unemployment rate in 2019 was 3.2%. According to the 2019 County Health Rankings Report by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Knox County residents ranked 9 out of 95 Tennessee Counties in overall health. Knox County residents have the following health indicators that are at or above the national benchmarks: Knox - TN - National Adult Smoking: 20% - 22% - 14% Adult Obesity: 32% - 33% - 26% Drug Overdose Deaths: 42 - 24 - 10 per 100,000 population Teen Birthrate: 22 - 33 - 14 of every 1,000 teenage girls Part VI, Line 5: Parkwest, in conjunction with its parent company, Covenant Health, uses any available surplus of receipts over disbursements to expand and modernize the facility and to support the education of healthcare professionals, both of which serve to improve patient care and serve the unmet needs of the community.Covenant Health's Board of Directors serves as Parkwest's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of Parkwest.Parkwest maintains an open medical staff, with privileges available to all qualified physicians. Additionally, the hospital operates an active and accessible emergency department that accepts all patients regardless of ability to pay. Part VI, Line 6: Parkwest, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served.As a system, Covenant assures that business processes are in place at each facility to measure and report quality; to increase the role of compliance; and to integrate risk management, utilization review, peer review, mandatory reporting and quality improvement into one cohesive function. In this way, the system is able to use analytic tools to help identify any systemic inability to satisfy the various requirements on the part of the facilities.Parkwest operates a 462-bed acute care hospital in Knoxville, Tennessee, and provides a full range of inpatient and outpatient hospital services. It has been named as one of the nation's top 100 cardiovascular hospitals seven times of the award's eight-year history and offers a full cardiovascular service line that includes coronary bypass surgery, diagnostic and interventional cardiac procedures. Patients may also receive treatment in one of Parkwest's specialty centers, which include: - The Senior Behavioral Center, a 16-bed unit for older psychiatric patients - A Bariatric Surgery Center of Excellence - A Joint Replacement Center - A surgical center utilizing the BrainSUITE system for brain, spine, ear, nose and throat surgery.Parkwest also owns and operates Peninsula, a 155-bed psychiatric hospital located in Louisville, Tennessee. Peninsula has outpatient centers in Knox, Blount, Sevier and Loudon Counties. Peninsula is a valuable resource providing support for emergency rooms at the system's seven acute care hospitals. The affiliation makes for an accessible and efficient pathway for patients who require mental health services post-discharge.Parkwest and Peninsula patients benefit from the availability and ease of access to Covenant Health affiliated entities for services not provided by the hospitals themselves. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. Specialized services such as inpatient rehabilitation, cancer treatment, home health and hospice services are provided by affiliated entities. The Covenant Health system also enhances the patient's access to care through the provision of outpatient services in a variety of settings located throughout the service area. These include diabetes, wound care, and ambulatory infusion centers.The Fort Sanders Foundation seeks out community financial support for Parkwest and Peninsula. Funds are used for indigent patient care, medical equipment, outreach programs, services and staff.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently. 1 Knoxville Medical Mission Foundation 1932 Historic Ferry Way Knoxville TN 37922 300197352 501(c)(3) 7500 General support 1 0 Dialysis treatments & medical equipment for home use 17 171762 Cost Patient transportation & living expenses 2503 258951 Cost Pharmaceuticals for outpatients 4332 80376 Cost Mental Health support 100 946 Cost Patient assistance 750 5910 Cost Swaddle blankets for newborns Part I, Line 2: Grant funds are provided to charitable organizations for the purpose of enhancing and promoting health care and improving quality of life in the community. The organization has guidelines in place to review the eligibility of grantees, and all grants require written documentation and appropriate levels of approval. The organization also provides other post-hospital care assistance to eligible individuals. Funds are generally not tracked after being granted as the original eligibility and selection criteria have been met. X 1 1 0 1 0 0 0 0 0 0 0 James D VanderSteeg President & CEO 0 1123891 0 529000 0 146034 0 183500 0 23723 0 2006148 0 0 John T Geppi EVP/CFO 0 617248 0 272168 0 91155 0 11000 0 17517 0 1009088 0 0 Neil A Heatherly President & CAO 0 416495 0 125000 0 61580 0 11000 0 23724 0 637799 0 0 M Scott Hamilton VP - Financial Services 170882 0 30000 0 13068 0 8216 0 25781 0 247947 0 0 0 Elizabeth Clary VP-Behavioral Health 126699 0 20632 0 38246 0 7543 0 14795 0 207915 0 0 0 W Jason Draper VP - Support Services 151521 0 20611 0 5643 0 1231 0 25027 0 204033 0 0 0 Lynn C Cagle VP - Chief Nursing Officer 128499 0 17793 0 19688 0 6353 0 23543 0 195876 0 0 0 John G Kupfner MD Physician - Behavioral 360767 0 9200 0 810 0 16500 0 25700 0 412977 0 0 0 Donna G McKenzie MD Physician - Behavioral 280119 0 8000 0 3747 0 9453 0 10998 0 312317 0 0 0 Shyam P Vuyyuru MD Physician - Behavioral 281779 0 8000 0 1936 0 16500 0 24780 0 332995 0 0 0 Surendra K Sharma MD Physician - Behavioral 247010 0 8000 0 2647 0 15360 0 24029 0 297046 0 0 0 Melanie R Fuertes-Hunt MD Physician - Behavioral 238240 0 8000 0 959 0 16500 0 28399 0 292098 0 0 0 Part I, Line 1a Tax gross-up payments related to deferred compensation are provided to certain executives and managers. Amounts are included in taxable compensation. Part I, Line 3 Covenant Health, the parent company of Parkwest Medical Center, used the following methods in establishing the compensation of President/CEO, James D. VanderSteeg: compensation committee, independent compensation consultant, written employment contract, compensation survey or study, and approval by the board or compensation committee. Additional detail is provided in response to Form 990, Part VI, Section B, Lines 15a and 15b within Schedule O. Part I, Line 4b Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg. Employer contributions of $172,500 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2019 earnings of $29,629 are subject to a substantial risk of forfeiture. Amounts are combined with other compensation and considered for reasonableness. Compensation procedures are discussed in detail in Schedule O (Form 990, Part VI, Section B, Line 15a). Riley J Cagle Family member of Lynn C. Cagle, CNO 22351 Key employee Lynn C. Cagle, CNO, has a family relationship with Riley J. Cagle, an employee of Parkwest Medical Center. Amount represents fair market value compensation paid during 2019 for services rendered to the organization. 0 Form 990, Part VI, Section A, line 6 Covenant Health is the sole member of Parkwest Medical Center. Form 990, Part VI, Section A, line 7a Covenant Health's board of directors also serves as the board of directors for Parkwest Medical Center. Form 990, Part VI, Section A, line 7b Governance decisions of Parkwest Medical Center are subject to approval of the sole member, Covenant Health. Form 990, Part VI, Section B, line 11b The Covenant Health board of directors has delegated to its Finance Committee the full power and authority of the board to receive, review, approve, authorize the filing of, address and resolve audit or review issues, and otherwise take all action required or appropriate relative to IRS Forms 990 and other applicable tax filings. Prior to filing Form 990, management reviews with the committee the returns, discusses any material variations in the Form 990 as compared to those to be filed by the organization's affiliates, and answers any questions. At the conclusion of review and discussion, the Finance Committee approves the Form 990. Form 990, Part VI, Section B, line 12c Board members, officers and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health distributes a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest, and requires disclosure and resolution of employee conflicts of interest. Additionally, officers, employed physicians, and highly compensated employees are required to complete and sign an annual conflict of interest disclosure statement. Board members' conflicts of interests are addressed in the corporate bylaws, and board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity-Compliance Office maintains records that contain conflict of interest information obtained from board members, officers and employees. These records are available to be queried prior to engaging in business transactions. The Chief Compliance Officer reviews conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected, board members are expected to disclose any new conflicts that have arisen that affect pending board decisions. Officers and other employees are expected to report conflicts to the Chief Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Chief Compliance Officer, senior leadership, or the board of directors may review the conflict of interest. When appropriate, these bodies may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Chief Compliance Officer in conjunction with Covenant Health Executive Leadership determines how to appropriately manage the conflict. In any conflict involving a board member, such member is expected to recuse himself or herself from voting on matters related to the conflict. Form 990, Part VI, Section B, line 15 Form 990, Part VI, Section B, Line 15a: Overall compensation policies for Parkwest Medical Center, Covenant Health (Parent Company), and affiliates are set by the Compensation Committee of the board of directors ("the Committee"), which is comprised of independent members of the board. The Committee is guided in its decision-making process by an independent, nationally-recognized executive compensation consultant experienced in advising nonprofit hospital boards. The Covenant Health CEO is compensated by Covenant Health, and a detailed description of the compensation process is included on Covenant Health's 990. The process for Parkwest Medical Center's CEO is included in response to Part VI, Section B, line 15b. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Neil Heatherly, President and Chief Administrative Officer, are set by the Covenant Health CEO in consultation with the Senior Vice President-Human Resources, subject to approval of the Compensation Committee of the Covenant Health board of directors ("the Committee"), after review by and discussion with the executive compensation consultant ("the Consultant") to ensure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon the recommendations of the Consultant made after comparison with similar jobs in similar size health systems across the nation. Bonuses are recommended by the CEO and approved by the Committee conditioned upon receipt of a written opinion from the Consultant that total compensation for the executive is reasonable and consistent with fair market value. Base salary is initially targeted at midpoint and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0-35% of base salary based upon system performance and accomplishment of certain targets established by the CEO. Base salaries and annual bonus opportunities for other officers and key employees are based on targets established by historical compensation consultant data and the Covenant Health Compensation department. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0 - 20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership. Form 990, Part VI, Section C, line 19 Parkwest Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Per its tax exempt bond provisions, Covenant Health, the parent company of the organization, is required to file quarterly and annual consolidated and obligated group financial statements and other documentation with various bond insurers and other agencies, including the Electronic Municipal Market Access (EMMA) service of the Municipal Securities Rulemaking Board (MSRB). Any member of such a repository has access to these financial statements. The organization's governing documents and conflict of interest policy are not made publicly available. Form 990, Part IX, line 11g Intercompany Purchased Services: Program service expenses 1,872,548. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,872,548. Other Purchased Services: Program service expenses 26,426,853. Management and general expenses 205,911. Fundraising expenses 0. Total expenses 26,632,764. Sponsorship Fees: Program service expenses 12,840,580. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,840,580. Form 990, Part XI, line 9: Transfers of Capital 21,278,057. 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